Table 1. Characteristics of patients selected for the study.
| Patient and classificatio n |
Sex | Age (years) |
Time since first unprovoked seizure (years) |
Antiepileptic drugs at surgery |
MRI findings | Pathology | Immunohistochemical labeling |
|---|---|---|---|---|---|---|---|
|
Non-MTLE 1 |
F | 18 | 3 | Valproate, lamotrigine | Open lip schizencephaly, R hemisphere | Marked gliosis in cortex and white matter |
LM: β-dystroglycan |
| 2 | F | 28 | 21 | Lamotrigine, zonisamide, phenytoin |
Nonspecific, focal T2 signal hyperintensities in subcortical white matter, R frontal lobe |
Mild to moderate neuronal loss with severe reactive gliosis. Abnormal lamination and clustering of neurons. |
LM: MCT2, β-dystroglycan |
| 3 | M | 4 | 2 | Oxcarbazepine | Abnormal signal of R amygdala, hippocampal head and parahippocampal gyrus with cyst near R hippocampal head |
Oligodendroglioma | LM:β-dystroglycan |
| 4 | F | 49 | 13 | Carbamazepine XR, phenytoin, lamotrigine |
Large mass in R frontal and R temporal lobes |
Oligodendroglioma and ganglioneurocytoma |
LM: MCT2, β-dystroglycan |
| 5 | F | 38 | <1 | Levetiracetam | Nonenhancing R hippocampal lesion | Glioma | LM: MCT2, β-dystroglycan |
| 6 | M | 13 | 9 | Phenytoin, levetiracetam, carbamazepine |
Large porencephalic cavity in the R MCA distribution with surrounding gliosis. Compatible with remote R MCA infarct. |
Frequent heterotopic neurons in molecular layer of cerebral cortex |
LM: MCT2 |
| 7 | M | 6 | Levetiracetam, lamotrigine | Abnormal gray matter with local mass- effect involving L frontal cortex. Possible localized hemimegalencephaly and cortical dysplasia. |
Cortical dysplasia | LM: MCT2, β-dystroglycan | |
| 8 | M | 69 | 7 | Phenytoin | Neoplastic lesion, R temporal lobe | Oligodendroglioma | LM: MCT2 |
| 9 | F | 10 | 5 | Lamotrigine | R temporal tumor | Low-grade astrocytoma | EM: MCT2 |
| 10 | M | 28 | 26 | Carbamazepine, acetazolamide |
Ectopic gray matter adjacent to L anterior horn. High-signal by FLAIR in R posterior temporal lobe with corresponding low T1 signal. Possible bilateral hippocampal atrophy. |
Heterotopic neurons in the molecular layer of the dentate gyrus. Subpial glial cell proliferation. |
EM: MCT2 |
| 11 | M | 44 | 26 | Carbamazepine, clonazepam |
Possible R mesial temporal sclerosis | Hippocampus w/mild, diffuse neuronal loss and mild to moderate increase in number of white matter glial cells. |
EM: MCT2 |
|
MTLE 12 |
F | 17 | 5 | Oxcarbazepine, lamotrigine, carbamazepine |
Heterotopic gray matter in posterior R temporal lobe white matter with extension to the atrium and body of the right lateral ventricle. |
Hippocampal sclerosis | LM: MCT2 |
| 13 | M | 57 | 39 | Phenytoin, carbamazepine, topiramate, levetiracetam |
Mesial temporal sclerosis | Hippocampal sclerosis | LM: β-dystroglycan |
| 14 | F | 51 | 48 | Levetiracetam, pregabalin | R mesial temporal sclerosis | Hippocampal sclerosis | LM: MCT2, β-dystroglycan |
| 15 | F | 40 | 28 | Felbamate, topiramate, gabapentin, carbamazepine |
L hippocampal sclerosis | Hippocampal sclerosis | LM: MCT2 |
| 16 | F | 42 | 7 | Levetiracetam, oxcarbazepine |
R hippocampal sclerosis | Hippocampal sclerosis | LM: MCT2, β-dystroglycan |
| 17 | F | 40 | 37 | Carbamazepine, levetiracetam, zonisamide |
L hippocampal sclerosis | Hippocampal sclerosis | LM: β-dystroglycan |
| 18 | M | 62 | 56 | Valproate, levetiracetam, phenytoin |
L mesial temporal sclerosis | Hippocampal sclerosis | LM: MCT2 |
| 19 | F | 40 | 27 | Carbamazepine, levetiracetam |
Increased T2 signal, L hippocampus | Hippocampal sclerosis | LM: MCT2, β-dystroglycan |
| 20 | F | 30 | 22 | Zonisamide, carbamazepine XR |
R mesial temporal sclerosis | Hippocampal sclerosis | LM: β-dystroglycan |
| 21 | F | 51 | 11 | Carbamazepine | L mesial temporal sclerosis | Hippocampal sclerosis | EM: MCT2 |
| 22 | F | 37 | 11 | Primidone, lamotrigine | R mesial temporal sclerosis | Hippocampal sclerosis | EM: MCT2 |
| 23 | F | 15 | 5 | Carbamazepine XR, lamotrigine |
L mesial temporal sclerosis | Hippocampal sclerosis | EM: MCT2 |
| Patient and classification | Sex | Age (years) | Cause of death | Immunohistochemical labeling |
|---|---|---|---|---|
| Autopsy 1 | M | 33 | Adenocarcinoma of lung with widespread metastases | LM: MCT2, β-dystroglycan |
| 2 | M | 52 | Myocardial infarct, coronary atherosclerosis | LM: MCT2, β-dystroglycan |
| 3 | F | 49 | Ruptured berry aneurysm, R posterior inferior cerebellar artery | LM: MCT2 |
| 4 | F | 76 | Peritonitis | LM: MCT2 |
| 5 | M | 61 | Myocardial infarct, cardiovascular atherosclerosis | LM: β-dystroglycan |
| 6 | F | 62 | Dementia, mixed type | LM: β-dystroglycan |
Abbreviations: L, left; MCA, middle cerebral artery; R, right; XR, extended release